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Biomedical subjects

K Okada

Publications and source records attributed to K Okada.

At least 919 records · Page 51Linked to original sources
PubMed1993

[Traumatic tricuspid regurgitation--report of two cases and review of operated cases].

Two cases of nonpenetrating traumatic tricuspid regurgitation were reported. The first case, a 46-year-old man who had an episode of traffic accident 21 years ago, was admitted with complaints of peripheral edema and dyspnea on exertion. The second case was a 16-year-old man who noted to have cardiac murmur and cardiomegaly after 4 years of a traffic accident. In both cases, cardiac catheterization showed increased right atrial pressure with high v wave, and echocardiogram showed severe tricuspid regurgitation with ruptured chordae tendineae of the anterior leaflet. Tricuspid valve replacement was performed successfully in both the cases. Twenty-two operated cases of traumatic tricuspid regurgitation have been reported in Japan; 17 of ruptured chordae tendineae, 3 of ruptured papillary muscle, and 2 of primary laceration of anterior leaflet. The patients with ruptured papillary muscle were operated from 2 months to 7 years (average 4 years) after trauma, while those with ruptured chordae tendineae were operated from 5 months to 25 years (average 10 years) after trauma. Tricuspid valve replacement was performed in 17 of 22 cases. From the review of 22 cases, tricuspid valve replacement should be indicated for traumatic tricuspid regurgitation in consideration of the severity of valve destruction regardless of the interval after trauma.

Adolescent↗
PubMed1993

Influence of factors in the digestive tract on the progression of chronic renal failure.

To elucidate the mechanisms by which factors in the digestive tract influence the progressive chronic renal failure in rats, we employed the oral adsorbent, AST-120, which can adsorb certain uremic toxins in the gastrointestinal fluid. Administration of AST-120 firstly delayed the appearance of systemic hypertension, secondly delayed the increase in the amount of urinary protein excretion, and finally delayed the emergence of glomerular hypertrophy and glomerulosclerosis. The data obtained did not provide evidence for an inhibitory effect of AST-120 on hypertension. Our results therefore suggest that a pressor substance or its precursor exists in the digestive tract of rats with chronic renal failure.

Adsorption↗
PubMed1993

How long can continuous ambulatory peritoneal dialysis be continued?

We investigated how long continuous ambulatory peritoneal dialysis (CAPD) could be continued in the face of peritoneal sclerosis. 15 CAPD patients with no experience of peritonitis were selected and the time limitation for CAPD was examined retrospectively, based on the dialysate osmolality, serum creatinine concentration, etc.. The values for the dialysate osmolality and serum creatinine concentration increased gradually with the duration of CAPD and were significantly increased from 6 months. 5 patients whose serum creatinine concentration during the first 6 months after initiation of CAPD increased more than 5 mg/dl, could not continue CAPD for more than 24 months because of the appearance of peritoneal membrane failure. When the time limitation for CAPD was assessed in 10 stable patients, close relationships between the mean dialysate osmolality and duration of CAPD (Y = 0.52X + 351.25, r = 0.83, P < 0.01), and between the mean serum creatinine concentration and duration of CAPD (Y = 0.18X + 6.84, r = 0.95, P < 0.001) were recognized. If the practical limitation for CAPD was set at 400 mOsm/l in terms of the dialysate osmolality or 20 mg/dl in terms of serum creatinine concentration, its value became 94.1 months or 73.1 months, respectively. It is concluded that the time limitation for CAPD can be expected to be approximately 6 to 8 years in stable CAPD patients, and we need to resolve CAPD-induced problems involving the peritoneal membrane in order to continue CAPD for more than 10 years.

Adult↗
PubMed1993

Oral 1,25(OH)2D3 pulse therapy for the treatment of secondary hyperparathyroidism.

We examined the effect of oral 1,25(OH)2D3 pulse therapy in hemodialyzed patients with secondary hyperparthyroidism (2 degrees HPT). Prescription of 6.0 micrograms 1,25(OH)2D3 once a week combined with calcium carbonate as a phosphate binder during the last 5 days a week for 12 weeks resulted in improvement of mild to moderate 2 degrees HPT despite no significant differences in serum total calcium and phosphate concentration. In addition, the effect was greater in cases with mild 2 degrees HPT. A single administration of 6 micrograms 1,25(OH)2D3 reduced the parathyroid hormone concentration in patients with mild 2 degrees HPT or with a short duration of hemodialysis. Tmax of the serum 1,25(OH)2D3 after single administration of 6.0 micrograms 1,25(OH)2D3 was individually different (range, 0.4-20.9 hrs). It is recommended that early employment of oral 1,25(OH)2D3 pulse therapy be undertaken once a week combined with prescription of calcium salt as a phosphate binder during the last 5 days a week for the treatment of 2 degrees HPT refractory to conventional therapy, since there is no risk of aluminum accumulation with satisfactory control of the serum total calcium and phosphate concentration.

Administration, Oral↗
PubMed1993

[Successful operation for two cases of an aneurysmal bone cyst of the rib].

An aneurysmal bone cyst involving the rib is very rare. A 43-year-old man and 49-year-old woman complained of pain and swelling on the chest. X-ray and CT revealed a local expansion and honeycomb lesion of the right 9th rib. Surgical excision of the rib were performed to remove the tumor completely. The histopathological examination revealed that the lesion consisted of many cavities filled with blood and trabecullae containing osteoid tissue and giant cells, showing it to be an aneurysmal bone cyst. Because of the potential for the rapid growth and difficulty in differentiation between benign and malignant rib tumor, an excisional biopsy should be considered for the treatment of an aneurysmal bone cyst of the rib.

Adult↗
PubMed1993

[The efficacy of semiselective intraarterial infusion therapy in advanced or recurrent gastric cancer].

We use CDDP and have compared the semiselective intraarterial infusion (ia group) with intravenous infusion (i.v. group) by measuring levels of the administered drug in blood and the abdominal organ tissues. In portal blood, the ia group showed a significant increase compared with the i.v. group. The patient tissue level was compared between the two groups. Higher levels were obtained in the peritoneum in the ia group. These results suggest that semiselective intraarterial infusion therapy is effective in peritoneal dissemination.

Cisplatin↗
PubMed1993

[Effect of thiazide on urinary citrate excretion].

In order to study the effect of thiazide on urinary citrate excretion, we measured sodium dependent citrate uptake by rat renal cortical brush border membrane vesicles (BBMVs) and analyzed acid-base balance with or without thiazide treatment. 5-weeks male Wistar rats (Jcl) were housed in metabolic cages, given 0.1 mg/100 g BW/day hydrochlorothiazide (HCTZ) by a gastric tube once a day for 3 weeks (thiazide treated rats). Arterial blood was taken from aorta and BBMVs were prepared with divalent cation precipitation method. Citrate uptake was measured by a Millipore rapid membrane filtration technique. Oral treatment of HCTZ for 3 weeks showed a significant increase of urinary citrate excretion in both concentration and daily excretion. The sodium dependent citrate transport was observed in rat renal brush border membrane (BBM). But no significant effect of oral HCTZ was observed on acid base balance and sodium dependent citrate uptake in rat renal BBM. These data suggested that the stimulative effect of thiazide on citrate excretion was not via sodium dependent citrate transport in rat renal BBM.

Animals↗
PubMed1993

[Study on the initiation time of drug treatment for chronic renal failure].

In order to examine the initiation time of drug treatment for chronic renal failure by the removal of certain substances which are accumulated in the digestive tract, experiments were carried out on 60 male Sprague-Dawley rats weighing 285-325g. The rats were first subjected to 2/3, 3/4 and 4/5 nephrectomy (n = 20). The experiments were begun at 2 weeks after the surgery, and were performed over an 8-week period. Half of each group of nephrectomized rats (n = 10) was administered the oral adsorbent, 1 g/day of Kremezin (AST-120, Kureha Chemical Industry Co, Tokyo), and pair feeding was done in each group of nephrectomized rats. The administration of Kremezin delayed the occurrence of glomerular hypertrophy, glomerulosclerosis, hypertrophy of the glomerular epithelial cells, flattening of the tubular cells, dilation of the tubular cavity and infiltration of monocytes into the interstitium in the 2/3 nephrectomized rats. In addition, the administration of Kremezin delayed the appearance of proteinaceous cast formation in the tubules, ballooning of the tubular cells, an increase in systemic blood pressure and an increase in urinary protein excretion in the 3/4 and 4/5 nephrectomized rats. These findings indicated that the correction of an abnormal milieu within the digestive tract in chronic renal failure can delay its progression. Since the level of the creatinine clearance in the 2/3 nephrectomized rats was equal to approximately 60% of the creatinine clearance in normal rats, it is suggested that drug treatment for chronic renal failure with Kremezin should be initiated before the level of the creatinine clearance decreases to 60% of creatinine clearance in normal human.

Administration, Oral↗
PubMed1993

[Evaluation of surgical treatment for spontaneous pneumothorax].

To evaluate the effect of surgical treatment for spontaneous pneumothorax, we examined eighty patients who underwent the surgical treatment. Out of these, thirty five patients (53.0%) were the recurrent episode of the disease, since we vigorously chose surgical treatment for the second attack of the disease. Operative complications were observed in 6 cases (7.1%) including 2 cases of lasting air leakage and 1 case of bleeding, pneumonia, wound infection and atelectasis. Postoperative recurrence was not seen. From a viewpoint of prevention of the postoperative recurrence, the surgical treatment is effective and safe method.

Adolescent↗
PubMed1993

[The changes of intraocular pressure during sevoflurane anesthesia in children].

We investigated the intraocular pressure (IOP) during sevoflurane anesthesia in 20 children. We measured IOP, mean blood pressure and heart rate at 7 points in each subject. IOP was measured first after induction, then after vecuronium administration, immediately after intubation, and 5, 10, 15, 30 min after intubation. There were no significant changes in IOP and hemodynamics during sevoflurane anesthesia. We consider that the optimal time for IOP measurement is 5 or 10 min after intubation and the normal range of IOP is within the mean +/- 2 standard deviation. The peak values of IOP were 19.2 and 18.8 mmHg at 5 and 10 min after intubation. The results suggest that normal range of IOP is below 20 mmHg during sevoflurane anesthesia in children.

Anesthesia, Inhalation↗
PubMed1993

[Clinical assessments on pre-treatment prognostic factors in 138 patients with advanced prostatic carcinoma (stage D2)].

We investigated the prognostic factors in 138 patients with stage D2 prostatic cancer by univariate and multivariate analyses. Analysis was restricted to 8 pre-treatment parameters, that is, age, general condition (PS), pain, number of metastases on bone scan, acid phosphatase value, Gleason's primary pattern, secondary pattern, and nucleoli grading. In addition, 4 therapeutic modalities except routine endocrine therapy, that is, castration, oral administration of estramustine phosphate, of 5-fluorouracil (5-FU) or its analogue, and combination chemotherapy, during the whole treatment period were included in the analysis. Univariate analysis (Kaplan-Meier method) showed only PS to be a significant prognostic factor. Multivariate analysis (Cox's proportional hazard model) revealed that PS, Gleason's primary pattern, oral administration of 5-FU or its analogue and combination chemotherapy were significant prognostic factors. However, patients treated by combination chemotherapy had poorer prognosis and chi 2 values of combination chemotherapy was the highest among the four parameters cited above. These results suggested that the 8 pre-treatment parameters examined in this study were not sufficient for predicting the prognosis of each patient.

Acid Phosphatase↗
PubMed1993

[Medtronic model 6500 temporary myocardial pacing lead: a report of clinical assessment until three weeks after cardiac surgery].

Medtronic model 6500 heart wire as a right ventricular electrode was assessed in 41 postoperative cases. R-wave amplitude, slew rate, peak-to-peak, output, current, and resistance were measured by Medtronic A-V pacing system analyser, model 5311, for three weeks after open heart surgery. These parameter changed until the 7 th postoperative day, but did not change significantly thereafter. Output and current did not exceed beyond 10 V and 20 mA respectively, where there is limitations of usually available pacemaker. No complication was encountered. These results showed that this heart wire was reliably useful even until 3 weeks after open heart surgery.

Adolescent↗
PubMed1993

Osteogenic melanoma. A rare variant of malignant melanoma.

Osteogenic melanoma is a rare variant of malignant melanoma; only eight cases have been reported. To characterize this unusual neoplasm further, we present four new cases. Two patients were men and two were women (average age, 56 years; range, 47-78 years). All tumors arose from acral lentiginous melanomas. Three were subungual finger lesions and one was on the sole of the foot. All four had been previously diagnosed as or were suspected to have been primary osseous lesions. The vertical growth components were high-grade, amelanotic sarcomatoid malignancies with abundant osteoid matrix. Two tumors also had chondroblastic differentiation. Cells with epithelioid features, including prominent eosinophilic nucleoli, were discernible in every tumor. Regional lymph node metastases in two cases retained osteocartilaginous differentiation, whereas metastatic cells in another case were purely epithelioid. Tumor cells in every case were immunoreactive for S-100 protein and vimentin, and non-reactive for cytokeratin. Two tumors also expressed HMB-45. Melanosomes were identified ultrastructurally in every tumor. Follow-up information was available on every patient. Three developed regional lymph node metastases and are currently alive and well after 14, 39, and 101 months. The fourth patient died of metastatic uterine carcinoma 20 months postoperatively. The differential diagnosis of osteogenic melanoma includes osteosarcoma as well as atypical fibro-osseous proliferations. Clinico-pathologic features that support a diagnosis of osteogenic melanoma include junctional activity, absence of primary bony involvement, regional nodal metastases, immunoreactivity for S-100 protein and/or HMB-45, lack of cytokeratin reactivity, and ultrastructural identification of melanosomes.

Aged↗
PubMed1993

[A patient with stage IV gastric cancer responding to combination chemotherapy with 5-FU, leucovorin and CDDP].

The patient was a 44-year-old male with gastric cancer accompanied by pancreatic invasion and metastasis to the periaortic lymph nodes. Combination chemotherapy with 5-FU, leucovorin (LCV) and CDDP (FLP therapy) was preoperatively given. Pancreaticoduodenectomy was carried out as absolutely noncurative resection. FLP therapy was continued postoperatively, and resulted in disappearance of the metastases in the periaortic lymph nodes on CT. As there were no findings of recurrence, the patient was regarded as being in complete response. In addition, the performance status improved from Grade 2 to Grade 0. Since the three-drug combination therapy induced only slight adverse reactions (Grades 1-2), it could be safely carried out at the outpatient department. Thus, combination therapy with 5-FU, LCV and CDDP is thought to be effective against gastric cancer.

Adenocarcinoma↗
PubMed1993

[Intrapleural regional analgesia in pain management after chest trauma].

Twelve chest trauma patients with severe pain were studied. All of them had multiple rib fractures, hemopneumothorax or pulmonary contusion, and needed the continuous chest drainage. 16 G epidural block catheter was introduced 20 cm into the apex of the pleural space. Furthermore, another catheter was placed into the base of the pleural space. After injecting 1% lidocaine 10 ml, the analgesic effect, the analgesic range according to injected point (apex or base), and the changes of vital signs, PaO2/FIO2 and PaCO2 were evaluated. The average pain scale before interpleural regional analgesia (IPA) was 2.9 and 1.0 after 15 min. The time to return to pre-IPA condition took about 150 min. The mean blood pressure did not show significant changes, although pulse and respiratory rate decreased. PaCO2 did not show significant changes, although PaO2/FIO2 increased significantly. The present study indicates that IPA in chest trauma reduces pain and improves PaO2/FIO2 significantly without circulatory changes. It was reported that it was difficult to obtain effective pain relief after thoracotomy. However, when the catheter is placed at the apex, it seems to be effective to relief pain on the chest site. In conclusion, IPA seems to be simple, effective and useful to remove pain from chest trauma when epidural block is difficult to induce.

Adolescent↗
PubMed1992

Tumor-associated M(r) 34,000 and M(r) 32,000 membrane glycoproteins that are serine phosphorylated specifically in bovine leukemia virus-induced lymphosarcoma cells.

Tumor-associated antigens that are expressed in tumor cells of cattle with enzootic bovine leukosis (EBL) were analyzed previously by use of 13 monoclonal antibodies. We biochemically identified one of the tumor-associated antigens, which is recognized by the c143 monoclonal antibody, as two glycoproteins, each having an apparent molecular weight of 32,000 or 34,000. These glycoproteins were found in the plasma membrane of peripheral blood lymphocytes of both bovine leukemia virus (BLV)-free normal and BLV-infected cattle. With the progression of EBL, the proportion and the absolute number of cells positive for the tumor-associated antigen increased. Moreover, the level of the M(r) 34,000 component, which was susceptible to cell-surface labeling, increased over the level of the M(r) 32,000 component. Partial proteolytic peptide mapping with V8 protease and deglycosylation analysis revealed that the two glycoproteins most likely have an identical M(r) 30,000 polypeptide portion but have different N-linked oligosaccharide portions. Both glycoproteins were found to be phosphorylated at serine residue(s) in EBL-derived B-lymphoid cell lines and in tumor cells and peripheral blood lymphocytes from cattle with EBL, but not in peripheral blood lymphocytes from BLV-free normal cattle and BLV-infected cattle without any evidence of tumor, suggesting that the phosphorylation of these glycoproteins is related to the transformed state of the BLV-infected B-lymphoid cells.

Animals↗
PubMed1992

Tissue-type plasminogen activator, type 1 plasminogen activator inhibitor and their complex in plasma with disseminated intravascular coagulation.

The levels of tissue-type plasminogen activator (t-PA), type 1 plasminogen activator inhibitor (PAI-1), and t-PA/PAI-1 complex antigens were analyzed in the plasma of disseminated intravascular coagulation (DIC) patients and healthy controls. Other fibrinolytic parameters such as the levels of plasminogen, alpha 2-antiplasmin (alpha 2-AP), plasmin/alpha 2-AP (PAP), and D-dimer were also estimated to clarify the fibrinolytic states in these plasmas. The antigens of t-PA, PAI-1, and t-PA/PAI-1 complex were found to increase from 8.5 +/- 4.3, 54.4 +/- 21.2, and 8.6 +/- 3.5 ng/ml in normal plasma to 36.4 +/- 25.1, 106.8 +/- 54.7, and 46.6 +/- 34.5 ng/ml in DIC plasma, respectively. The molar ratio of total t-PA to total PAI-1 was 1:6 and 1:3 in normal plasma and DIC plasma, respectively, indicating an enhanced fibrinolytic state in the DIC plasma. The DIC plasma revealed a significant consumption of plasminogen (62.1 +/- 27.8%), and alpha 2-AP (63.7 +/- 25.3%) and an increase in PAP (2.6 +/- 2.7 micrograms/ml) and D-dimer (3.9 +/- 10.7 micrograms/ml). These results suggest that the production and secretion of t-PA and PAI-1 from endothelial cells were enhanced in DIC, resulting in an increased t-PA/PAI-1 complex with dominant fibrinolytic activity.

Disseminated Intravascular Coagulation↗